The Relationship Between Aortic Dissection and Aneurysm and Coronary Atherosclerosis: Its Effects On Prognosis

Between J anuary 1993 and August 1997, 215 patients had been treated in the Ege Unviversity Medical Faculty, Department of Cardiovascular Surgery because of various aortic lesions. Aortic dissection was detected in 70 (32.6%) and aneurysm in 145 (67.4%) patients. Coronary angiography was perfonned to search for concomitant coronary artery disease in 118 (54.8%) of them. Concoınitant coronary artery disease was detected in 10 (14.3%) patients with aortic dissection and in 42 (28.9%) patients with aortic aneurysm. In the group of abdominal aortic aneursyın, concoınitant coronary artery disease was detected in 29 (82.8%) among 35 patients to whom coronary angiography was perfonned. Coronary artery bypass surgery (CABG) was performed in 9 patients who had aotic dissection and in 21 patients who had aortic aneurysm. PTCA was perfonned in 5 patients also. Eighteen (25.7%) patients who had dissection and 22 (15.2%) patients who had an aneurysm died. As a conclusion, the concomitant ineidence of coronary disease and cardiac mortality are considerable among patients with aortic disease and especially in those with abdominal aortic aneurysm. The preoperative determination of the severity of coronary artery disease and eventual revascularization by CABG or PTCA before or during aortic surgery, is crucial.